Dear Dr. Baraki, My Dr. recently did blood work on me. I am a 71 year old active female. One of the things I do is lift weights three days a week. I feel I eat a healthy diet. I try to limit my intake of red meats. I eat Quaker whole grain rolled oats and 100% whole wheat bread although I don’t eat much bread. I eat fruits and vegetables and lots of salads. I do not smoke . My alcohol is very limited. My lab results for the Lipid Panel are as follows: Cholesterol value 219, HDL cholesterol value 76,
Triglycerides value 72, LDL cholesterol value 129. My doctor recommended I cut back sugars and carbs. She named white rice, pasta, potatoes are not good options. She said eating eggs and avocado is a better option than oatmeal. She said berries such as raspberries and blue berries are better options than a banana saying bananas are full of carbs. She also suggested increasing my fiber. She suggested I start using Flax seed oil. Should I be concerned about my LDL cholesterol value? If yes, what changes do you suggest I make to my diet to reduce the LDL? Thank you so much Dr. Baraki!
Hi there, and welcome to the forum.
Overall these numbers are not very concerning for someone who does not have any known heart disease history (at least, based on what you’ve reported here). I wonder how much emphasis your physician is putting on the total cholesterol measurement, and perhaps is not accounting for the fact that your HDL-C is so high (which is a protective factor), since this actually contributes to the total number.
The best number from the standard cholesterol panel involves taking the total cholesterol (219) and subtracting the HDL-C (76), which gives something called the non-HDL-C. For you, this number is 143 mg/dL. For individuals who are at average risk (i.e. do not have a history of heart disease or other major risk factors), we typically aim to get this number below 130 mg/dL. You are not too far off, and the impression I get is that you are doing very well overall and I would not be excessively concerned about this based on the information you’ve provided here.
As far as recommended dietary changes, I would encourage:
-increasing dietary fiber intake (from foods like oats, lentils, chickpeas/other beans, and the fruits and vegetables you’re already consuming)
-consuming a serving or two of fatty fish (like salmon) per week
-incorporating some mixed nuts (like walnuts, almonds, etc.) into your diet on a regular basis.
I do not share your physician’s concerns about bananas, oatmeal, or carbohydrates in general.
This would be in addition to continuing your regular weight lifting, and if you’re able to add some aerobic activity each week that’d be great too.
Keep up the great work!
For a vegetarian who would use supplements, how much EPA and DHA would you recommend per day and how many days per week would you recommend?
1 g/d or more of combined EPA+DHA would be reasonable.
Just to be clear, that’s 1 gram per day, 7 days a week?
Sure. There are no concrete guidelines here, so I just suggested something that would be reasonable for that population.
It appears to be about the same as the dose from two servings of salmon.
Thank you!